Sunday, Sep. 24, 2006

How I Lost My Hand But Found Myself

By MICHAEL WEISSKOPF

In his book Blood Brothers, TIME senior correspondent Michael Weisskopf weaves his own tale of losing a hand in Iraq with the stories of three soldiers who also spent time at Amputee Alley, Ward 57 of Walter Reed Army Medical Center in Washington. In this excerpt, the action begins on Dec. 10, 2003, as Weisskopf, 57 at the time, is on assignment in Baghdad, riding in the back of an open humvee along with TIME photographer James Nachtwey and two young soldiers, Private Orion Jenks and Private First Class Jim Beverly.

The army convoy rattled through Al-Adhamiya like a carnival roller coaster, each turn as blind as the next. Not that the soldiers could see much anyway. Night had fallen on the old Baghdad quarter, a byzantine maze lit only by kerosene lamps flickering from rugged stone houses. We moved warily in the darkness, patrolling for insurgents in blind alleys custom-made for ambushes and narrow passages perfect for concealing roadside bombs. It was anyone's bet who faced a more dire risk, the hunted in terrorist cells or the hunters in humvees, along with whom I was riding under a half-moon. I was in Iraq to profile the American soldier as "Person of the Year" for TIME magazine. It was a dream assignment, a chance to escape Washington and work in exotic environs on a big story.

We emerged into Al-Adhamiya's main marketplace, a large treeless square that was host to what looked like a block party in full swing. Old men, rocking back and forth on tiny stools, shuffled dominoes. Boys volleyed soccer balls. Women veiled in black fed their children from stalls of roasted chickens and shashlik. No one seemed to notice the foreign invaders passing by.

At first I thought it was a rock, the specialty of street urchins--a harmless shot against an armored humvee. I gazed down and spotted an object on the wooden bench 2 ft. away. The dark oval was as shiny and smooth as a tortoiseshell, roughly 6 in. long and 4 in. wide. None of my fellow passengers seemed to notice. I confronted the intruder alone, a journalist caught in a military moment. Something told me there was no time to consult the soldiers.

I rose halfway, leaned to the right, and cupped the object. I might as well have plucked volcanic lava from a crater. I could feel the flesh of my palm liquefying. Pain bolted up my arm like an electric current. In one fluid motion, I raised my right arm and started to throw the mass over the side of the vehicle, a short backhand toss. Then everything went dark.

The humvee bed was cold and hard, an inhospitable place to awaken. I struggled to sit up and fell back. My right leg burned from knee to hip. Blood was oozing from it; my right arm felt heavy and numb. Was I having a nightmare? The hollow, faraway sound of voices was dreamlike. I shook my right arm, trying to wake it up. Still no response. I elevated it to see why.

My wrist looked like the neck of a decapitated chicken. The wound was jagged, the blood glistening in the light. My mouth was dry, my brow soaked in sweat; my heart beat quickly and weakly, little dings in my chest.

All sound and sight dimmed, as my thoughts turned inward. This is not how I pictured my life ending: futilely and unglamorously, on the frigid floor of a truck, thousands of miles away from anyone I loved.

After medic Billie Grimes stopped the bleeding with an elastic cord, I was rushed in the humvee to a nearby brigade clinic and then medevacked to a U.S. Army hospital elsewhere in Baghdad for surgery to clean what was left of my arm and the shrapnel wounds in my right thigh. There, I learned that everyone else in the back of the humvee had survived, though Jenks had serious leg wounds, Beverly had knee and hand injuries and Nachtwey had taken shrapnel in his knees and abdomen. The next morning, a middle-aged nurse with blond highlights approached my bed.

"You're a hero," she said. "You lost a hand and saved lives."

Hero? I was feeling anything but valiant. Mangled. Pitiful. Disoriented. Scared. I was anxious about my ability to work again with one hand and to parent my children, who lived with me half-time in Washington. My son Skyler was 11 years old, the same age I had been when my father, a workaholic community newspaper publisher, dropped dead of a heart attack. Olivia was 8, roughly as old as my sister had been. I couldn't bear to think I might let such wrenching family history repeat itself.

Mostly, however, I was angry at myself for getting in the wrong humvee, releasing the grenade too slowly, even grabbing it in the first place. Nothing would have happened if I hadn't picked it up. Why had I been acting like a cowboy? Why hadn't I just left the damn thing alone?

"It was an impulsive act," I told the nurse. "If I hadn't picked it up, I'd still have a hand."

"You probably wouldn't have had a life," she retorted. "You and everyone else in the vehicle would have died. It wasn't an impulse; it was an instinct to survive."

TIME colleagues pushed for my transfer from Baghdad to the U.S. military hospital in Landstuhl, Germany. They then joined my friends and sister Leslie Flesch in lobbying to get acting Secretary of the Army Les Brownlee to admit me to Walter Reed Army Medical Center in Washington, making me the first reporter wounded in combat known to have received such treatment at the premier hospital reserved for soldiers.

Among the pros on the amputees' Ward 57 at Walter Reed, no one seemed fazed by my injury. But just the word amputation made me shudder. It conjured up a disjointed series of images: a childhood friend who had lost his leg in an auto accident; World War II veterans wheeled into ballparks for holiday games, their empty trousers or shirtsleeves pinned up. I had avoided mirrors all week. Now I feared seeing the startling reality in the faces of my family and friends who would be visiting on my first day in the hospital.

My fears turned out to be groundless. The one emotion everyone showed was happiness to see me alive, maimed or not. But two exchanges stood out. My sister surprised me with a gift: a 1900 silver dollar our gambler father had won in Las Vegas and given to her in 1956 when she was 8 years old.

I held my father's winnings and thought of the larger bet he lost. He deferred a family life to business success, and died before he had either. I had almost repeated the mistake. The realization put my father's death in a new light. I understood for the first time why he exited before getting to know me: he had gambled on a future that never materialized. It was a mistake I could begin to forgive.

I had gambled on a job assignment and had my own damage-control problems. Skyler had reacted angrily when he first heard of my injury. "He lied to me, he lied to me," Skyler shouted, referring to my parting words when I left for Iraq. "He promised me he wouldn't get hurt." According to my estranged wife Judith Katz, Skyler had moped and cried every day until I came home.

He was the first one through the door when visiting hours began. He and Olivia bounded onto my bed, showering me with hugs and get-well posters. Dressed in camouflage pants, Skyler before long had grabbed a roll of gauze and wound it around his right hand. He was identifying with my loss, a gesture I saw as a sign of forgiveness. I had shaken his sense of safety, the security blanket only a father can provide. Skyler's act of generosity capped a day of pardons across three generations of Weisskopf males.

Five days after I arrived Ward 57, surgeons removed another 3.3 in. of my forearm. They needed an inch of bone to free up enough loose skin to cover my wound; I had agreed to lose another 2 in. to make room for an electronic component in my future prosthesis so that my artificial hand would have the capacity to rotate rather than just open and close.

Myoelectric is the non-sci-fi name for bionic. A myoelectric hand works off tiny electrical signals released when muscles are contracted. The signals are picked up by electrodes that line the inside of a prosthesis and cover the muscles of a stump. Electrodes send the signal to a computer chip that instructs an electronic hand to open, close or rotate.

For long stumps like mine, forearm muscles located 3 in. below the elbow drove the process. Flexing the one on the outside of my forearm signaled a hand to open. Tensing the inner muscle would close it. My first lesson with an occupational therapist, Captain Kathleen Yancosek, focused on how to isolate those muscles. Using a tool called "Myo-boy," Captain Katie strapped electrodes onto each of my forearm muscles and plugged the other end of a cord into a laptop computer. The object was to generate a spike on the monitor by flexing the right muscle. I jerked, twitched and turned my stump. Nothing happened. I pumped again, hunting for the right spot, but the monitor stayed blank. When I grew frustrated, Katie had me close my eyes to map the muscle in my mind. I contracted. She let out a cheer: "You did it."

I opened my eyes and saw a tiny streak on the monitor. I squeezed, again, sending the spike higher. Unfortunately, as I kept practicing, the computer indicated that I was firing both muscles at the same time. I finally managed to distinguish one muscle from the other. But manipulating those tiny muscles was exhausting. My hospital gown was soaked in sweat.

Over the course of the next week, I spent at least an hour a day working on the Myo-boy, graduating to new levels of virtual reality. Finally, I simulated the mechanics of a virtual hand, including the wrist rotation I had paid for with two extra inches of my arm. It took an extra step, hitting both muscles at the same time.

Once the pain of surgery had subsided after Christmas, I began to suffer the bane of amputees: phantom limb pain. Sometimes I felt as if my fist was clamping tighter and tighter until my fingers were ready to explode. At other times, the Phantom could create the sensation of twisted fingers or a bent thumb.

Virtually everyone on Ward 57 had some phantom limb pain. Its cause remained as mysterious as it had been when a Civil War doctor coined the term to identify the complaints of soldiers whose injured limbs had been sawed off. Some experts believe the brain has a blueprint of body parts that persists even if they've been cut off. According to one theory, when the brain sends signals and receives no feedback, it bombards the missing limb with more signals. That aggravates the swollen nerves that once served it, inducing pain.

Doctors were as hard-pressed to treat phantom pain as they were to explain it. They resorted to trial and error, using remedies originally intended for other ailments that seemed to relieve nerve pain. I had a sampling on my nightstand: pills to combat seizures and depression, lozenges for bronchitis, allergy nasal spray, arthritis cream, medicated patches for shingles and an electro-stimulation device. It was hard to tell if any of them worked. The crushing, stabbing pain in my right hand flared and subsided--but never went away. Doctors said it might last a month, a year or a lifetime. Every amputee was different.

Phantom pain was a daily topic at OT--occupational therapy, the whittling porch for amputees. I made my first friends there. Most of my neighbors were half my age and from different backgrounds, small-town boys who had passed up college or blue-collar trades for a military life. I was urban, overeducated, untattooed and distrustful of uniforms and blind patriotism. But I soon discovered that I shared something with those soldiers larger than the differences in our biographies. We were men struggling for identity. The psychological scars of amputation ran deeper than those from conventional wounds of war. The blasts took away something deeply personal. None of us felt like the men who had gone to Iraq. We possessed the same minds; they just resided in different bodies.

The loss of my writing hand launched an assault on my self-image. If I couldn't be a reporter, then who was I? What would I do? The questions left me raw and wide open, no more so than my new friends who had honed their bodies for a completely different cause: war. The military represented the perfect synthesis of muscle and discovery, a place to play out feelings of invincibility. Now they confronted the world from a wheelchair or without an arm. Life looked different with no war to fight, orders to follow and comrades to love. The question was how to fill the void, and with what.

The tone in OT could shift from laughter to grave silence in the moment it took a soldier to scream in pain or explode into anger. Captain Katie segregated the angriest amputees. Her morning sessions bristled with tension. Metallica and Motorhead blared from speakers. One specialist who had trouble picking up a peg with his above-the-elbow prosthesis flung the $115,000 device against a wall. "I ain't doing it anymore," he shouted. Another threw the metal pedal of his wheelchair into a costly exercise machine.

My own moods fluctuated between anger and joy, frustration and triumph. But a feeling of melancholy prevailed as I came face to face with the larger tragedy beyond my own: stolen youth. Specialist Hilario Bermanis, 21, had been built like a fullback when he left his home in Micronesia to join the Army. Now he was hunched in a wheelchair, a thick neck and broad shoulders the only reminder of his once muscular body. He had lost his left hand and both legs above the knee to a rocket-propelled grenade in Baghdad.

Specialist James Fair, 22, had the cruelest of all fates; not only had he lost his sight, he had no hands for Braille or a cane. Still recovering from a brain injury in late December, he was wheeled into OT for sensory perception tests. He rolled his head back and forth, unresponsive to the therapists.

Three weeks of hospital life had taken a toll. I was 20 lbs. lighter, stooped, and as pale as a death-row inmate. Lacking a hand and 3 in. of forearm, my right limb hung almost a foot shorter than my left, the length of a child's arm attached to an adult's body. In a light-green hospital gown, I wasn't groomed for the runway or my date of Jan. 2. My girlfriend, Rebekah Edminster, had flown in from California for a 10-day stint.

A professional singer who lived in the artists' colony of Ojai, Rebekah, with whom I'd been romantically involved for a year, had kept her distance from Washington to avoid potential rivalry over my care. My sister had come for the first few days, and Judith, to whom I had been married for a decade, had been a continuous presence.

Rebekah arrived and kissed me as if nothing had changed. After a couple of hours, however, I sensed a little tension. I knew what was coming: a Washington Post story covering the Iraq incident had identified Judith as my wife. We were legally separated, but I apparently had left Rebekah with the idea that I had been divorced. She felt misled, telling a friend, "The grenade didn't kill him, but I'm going to."

I broached the subject, setting off a debate on the definition of marriage. I became angry and defensive. The room got close. I insisted I had never intentionally deceived her and said I needed support now, not doubt. "Listen, are we not friends?" Rebekah asked, locking her eyes on mine. I nodded yes."Then we'll get through this," she said.

On Jan. 8, 2004, I was released from the hospital and returned to my Washington home. My kids resumed their half-time life with me. Victor Vorobyev, a Russian emigre hired by TIME as my driver, chauffeured them to and from school. I overcame my nightmare of not being able to produce peanut butter sandwiches, with the help of technology from Captain Katie's OT kitchen. A sheet of sticky, rubbery material held the jar in place while I twisted off the top with my good hand and scooped.

Skyler and Olivia had no adult notions of loss or judgments about helping me. Not long ago I had tied their shoes. Now they were tying mine. I had patched up their cuts and scrapes; now they were changing my dressings. Their sweetness permeated the house. Before Iraq, I had thought of parenting as another job--a lot of work with little payoff. Now it was a love affair. Skyler and I picked up our running chess game. Olivia helped me cook dinners--"one-handed spaghetti" was our specialty.

A blizzard plowed into Washington one day in late January. We packed into Victor's car and went sledding. I stood at the bottom of the hill and watched. The sun sparkled on their snowsuits like tiny stars. They laughed and called out: "Watch this, Dad." "Did you see me, Daddy?" I waved and wept at these beautiful sounds, realizing how close I had come to never hearing them again.

Why did I risk it? I had scrutinized my motivation for picking up a grenade, but not the reason I had put myself in range of it. My rationale for going to Iraq as a career milestone no longer struck me as truthful. I already had scrapbooks full of big stories and enough money in the bank. I realized that something else had driven me, an old problem of self-worth: I was good because of what I did, not because of who I was. I had important roles as father, brother, lover and son. But without achieving in some material way, I felt empty and unseen. Journalism had provided a regular opportunity to reinvent myself. I had gone to Iraq for another fix.

Like any junkie, I thought only of myself, taking on a dangerous mission as if others didn't deserve a say, as if the chance of success for me was more important than the certainty of fatherhood for my kids. I didn't weigh the risk to them until I lay bleeding in the bed of a humvee, too late to spare them the fright.

It had taken a major loss for me to understand what I meant to others. Relationships rescued me. They got me out of Baghdad, into Walter Reed and back home. I received that help not because of a grade I had earned, a story written, or lives saved; it was for being me. I resolved to return the love by being less self-absorbed. I promised my kids I would stay out of war zones. My brother-in-law, Michael Flesch, came for a three-day visit, the longest time we had spent alone together in years. We hung out at Walter Reed by day and frequented Washington haunts by night.

And then there was Rebekah. I had finally realized why the divorce flap was so upsetting. Relationships meant everything to her, and I had shortchanged her on candor. The open heart she had brought to Walter Reed deserved better. I apologized in a couple of long phone calls to California, promising full disclosure as the bedrock of our relationship from here on out.

The arrival of my myoelectric arm in the first week of February was more exciting than a new pair of shoes--but no more comfortable to wear. Just getting it on was painful: my stump was still incredibly tender. If my former right hand had floated lightly, the fake one moved like a dumbbell--fat, clunky and heavy. Its 2 1/2 lbs. were concentrated in the electronic hand--the place farthest from the half-forearm. I kept bumping it into things. I named it Ralph, after the clumsiest kid in my grade school.

Ralph didn't work any better than he looked. The thumb and first two fingers opened and closed like a claw, the grossest of motor skills. The third finger and pinkie, which are employed by natural hands to carry things, were frozen. Ralph's wrist didn't bend. Despite weeks of training on a computer, I had difficulty with the basic functions: my stronger outer forearm muscle kept flexing and involuntarily opening the hand--even when I was trying to close it. I had no more success with the mechanism to rotate the wrist. The simultaneous contraction of both muscles was unnatural and hard to remember in real time. When I did it right, I couldn't keep the hand from spinning 360'0, an annoying loss of control--and embarrassing in public.

My disillusionment with Ralph grew. By the fifth day I was so frustrated I was ready to quit, thinking I'd be better off with one hand. On Feb. 11, I was invited to meet with my rehab team of eight people. Lieut. Colonel Paul Pasquina, medical director of the Army's amputee-care program, cited a few options to the myoelectric arm, including a body-powered prosthesis. They were lighter, unencumbered at the elbow, and ended in a hook. Pasquina said I might adopt a hook as a trademark that people would come to respect for its straightforward honesty.

I bristled. I wanted a prosthesis to disguise my deformity, not spotlight it. "The circles I travel in wouldn't be amused," I told Pasquina dismissively. I still was banking on an easy-fitting, lifelike substitute.

Dec. 10 marked the passing of a year since my injury. I knew I'd never regain what I had lost in penmanship, tennis, home repair, lovemaking, freedom from pain and dexterity. Even putting on a tie remained a challenge, one fraught with danger. Rushing to a TV appearance a few weeks earlier, I tried to knot one in the backseat of a taxi. I gripped the short end with my prosthetic hand, which began to spin uncontrollably, almost strangling me before I managed to extricate myself.

Despite occasional disasters, however, I was adjusting to a fake arm--thanks to certain modifications by prosthetist John Miguelez's team. Ralph had bit the dust, replaced by a more tapered, slightly lighter shell made of carbon fiber and acrylic resin. The modifications improved my range of motion and wardrobe--I could now button a dress shirt. But I was hardly wearing a second skin. The rigid shell chafed my forearm and got so hot in the summer that sweat dripped out of a small hole used to put it on.

Before Iraq, the technology of arm prostheses hadn't changed much since World War II. The tiny population of amputees created little market incentive. Miguelez used the burst in demand from Walter Reed to lean on manufacturers for progress. Before long, he was outfitting Iraq war amputees with an electronic hand that opened and closed 2 1/2 times faster and could be programmed to function at different speeds and grip strength.

The cosmetic arts also had improved. I received a silicone hand that was so lifelike it passed for real in social settings. But Pretty Boy, as I called it, kept tearing and afforded the precision of a boxing glove. It was too spongy to grasp anything small and too slippery to hold most objects for long.

Function was only part of the problem. The idea of trying to pass had begun to trouble me. It made me feel as if I had something to hide or be ashamed of. When I started to go bald, I shaved my head. No comb-overs, transplants or toupees for me. So why try to conceal a handicap? I was now proud of how I had lost my hand. The stump had a story to tell, regardless of my motivations for grabbing a grenade. Why not draw attention to it?

No one could miss my disability now. I put on a hook for Thanksgiving dinner and never took it off. It twisted into the end of my myoelectric prosthesis and turned 360'0 like an electronic hand. Only it worked better. Two silver talons opened like forceps, locked on to items and could pick a dime off the floor. Occasionally I screwed on a plastic, clawlike device known by the German word for grabber--Greifer--to move heavy objects, and I contemplated the long list of attachments--garden tools, spatulas, hammers and pool-shooting bridges--that were available by special order. I usually sported the hook, however, even if it aroused more fear than friendship among people I passed on the street. Some kids cowered. Friends accepted it and greeted me with a high-two. Rebekah, who had agreed to marry me several months earlier, thought my choice impudent but sexy and advised me on clothing to complement it--black was obviously best.

Half a year after I dismissed the suggestion from a Walter Reed doctor, the hook had become my trademark. It was brash, straightforward and pragmatic, virtues I cherished. I had left a lot of me behind in the Baghdad grenade attack. By its first anniversary, I was starting to reclaim it.

On July 3, Rebekah and I flew to Rancho Mirage, Calif., to celebrate my stepfather's 90th birthday. My mother hosted a party in the main ballroom of a swank hotel, the Lodge, for more than 60 family members and friends. Inevitably, when the subject of my accident came up and led to admiring comments, I felt a familiar twinge of guilt and embarrassment. I still couldn't embrace the notion of my so-called heroism.

Lying awake that night, I was reminded of a conversation I'd had with Hal Wain, a psychologist at Walter Reed. I had sought him out a few months earlier to discuss why I had grabbed the grenade. Wain said I had one overriding objective: self-preservation. "That's what all heroes are made of," he said. "I have learned from guys coming back that the instinct to survive, the instinct to take care of oneself or others, is incredibly potent. I really don't care if you did it for your needs or for others; you did it. The end result would have been the same--you saved people's lives."

Wain defined heroism as quick response to a changing environment, like a driver who swerves into another lane for the purpose of avoiding an oncoming car and, in the process, saves the life of his passenger. "That wasn't his intent," he said. "But being flexible and shifting is a higher level of intelligence. The people who can't change die."

I expressed my frustration that such a major ordeal had seemed to have so little effect on me--I was still the same impatient, competitive and self-critical person I'd always been. If I had acted so nobly, why didn't I feel more content? Wain's response struck me at the time as somewhat facile: the good deed, he said, had left me angry at myself. "You're thinking you could have done the same thing and didn't have to lose the hand. You love a perfect win and didn't get that perfect victory that you wanted and maybe deserved."

As I tossed and turned in the early hours of Independence Day, the simple truth of the psychologist's words hit me. It was true: I was mad at myself for failing to pull off a clean sweep. And it was that anger that was preventing me from savoring the achievement of a lifetime: saving my own skin and that of three others. My failure to get rid of the grenade before it exploded was only the first in a long list of wrongs I would have to pardon before I could finally put the ordeal behind me.

I had gone to Iraq for adventure and glory, discounting the interests of family and friends.

I had blithely ridden into danger with little to gain journalistically.

I had focused more on the loss of my hand than on the higher importance of preserving life.

The shortcomings were tough to swallow. But I was resolved to begin the process, keeping in mind Hal Wain's definition of heroism: self-preservation. By that standard, I had scored a perfect win after all.

The prize was the rest of my life.

Go to time.com to see a video interview with Michael Weisskopf and read a bonus excerpt from his book Blood Brothers